EBM and CQI Article of the Week 12.21.20

Think again of the beautiful Pensées – Blaise Pascal’s (1623-1662) masterpiece, born of quiet thought that has bridged time, culture, religion, and science:

Man is but a reed, the most feeble thing in Nature, but he is a thinking reed.  The entire universe need not arm itself to crush him.  A vapor, a drop of water, suffices to kill him.  But if the Universe were to crush him, Man would still be more noble than that which killed him, because he knows that he dies and the advantages the Universe has over him; the Universe knows nothing of this.

Maybe the lowest key of Nobel Prize notifications in recent history (Literature at least),….poet Louise Gluck?  Attached is her Wild Iris.  She adds dimension to Pascal – what is death and rebirth like for the other?  Using the metaphor of an iris, we can read her craft from several vantage points.

Ms. Gluck is described as a poet of “….austere intelligence, refined composition yet ordinary diction, a modern day Emily Dickinson, describes life-death-rebirth theme, focuses upon parents and siblings,….”   So, a lyricist for obstetrics, newborn medicine, and pediatrics?

Also attached is a Canadian view of “Value for Who?”  Zwicker laments the distance Canadian healthcare is from prioritizing value (health benefits gained/resources consumed).  Her neighbors to the south might say “Far worse here.”  The manuscript caught my attention because of the Avedis Donabedian references (the “Father of QI”) noting his plea for recognizing diminishing returns in healthcare,……maybe the principal challenge for us in 2021? 

Dr. Zwicker – “Value-based payment for services is the critical opportunity to consider the value of all services that impact childhood health, and requires special focus on quality and outcome measurement for all childhood health programs,.…[we must] move from theory to measurement and evaluation of value strategies.….”

Joe Kaempf, MD

District 8 Oregon Representative

Portland, OR

Volume 12, Number 49

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